经导管主动脉瓣置换时代主动脉瓣狭窄患者冠状动脉疾病的管理
Management of coronary artery disease in patients with aortic stenosis in the era of transcatheter aortic valve replacement.
作者信息
Belur Agastya D, Solankhi Naresh, Sharma Ravi
机构信息
Cardiovascular Disease Fellowship Program, University of Louisville School of Medicine, Louisville, KY, United States.
Jewish Hospital Cardiology, University of Louisville Jewish Hospital, Louisville, KY, United States.
出版信息
Front Cardiovasc Med. 2023 Jun 20;10:1139360. doi: 10.3389/fcvm.2023.1139360. eCollection 2023.
Abstract
Aortic stenosis (AS) is a common valve disorder among the elderly, and these patients frequently have concomitant coronary artery disease (CAD). Risk factors for calcific AS are similar to those for CAD. Historically, the treatment of these conditions involved simultaneous surgical replacement of the aortic valve (AV) with coronary artery bypass grafting. Since the advancement of transcatheter AV therapies, there have been tremendous advancements in the safety, efficacy, and feasibility of this procedure with expanding indications. This has led to a paradigm shift in our approach to the patient with AS and concomitant CAD. Data regarding the management of CAD in patients with AS are largely limited to single-center studies or retrospective analyses. This article aims to review available literature around the management of CAD in patients with AS and assist in the current understanding in approaches toward management.
摘要
主动脉瓣狭窄（AS）是老年人常见的瓣膜疾病，这些患者常伴有冠状动脉疾病（CAD）。钙化性AS的危险因素与CAD相似。从历史上看，这些疾病的治疗包括同时进行主动脉瓣（AV）置换术和冠状动脉旁路移植术。自从经导管AV治疗取得进展以来，随着适应证的扩大，该手术在安全性、有效性和可行性方面取得了巨大进步。这导致了我们对AS合并CAD患者的治疗方法发生了范式转变。关于AS患者CAD管理的数据大多限于单中心研究或回顾性分析。本文旨在综述有关AS患者CAD管理的现有文献，并有助于当前对管理方法的理解。
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